COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : : ______________________________ Plaintiff(s) Petitioner’s Name -against: ______________________________ Address (may be omitted for privacy) : ______________________________ : City, State, ZIP ______________________________ Defendant(s) : . .Telephone. (may. be .omitted). . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........ .... .. ...... Index No. Calendar No. JUDICIAL SUBPOENA THE PEOPLE OF IN THE _____________________ JUDICIAL DISTRICT COURT THE STATE OF NEW YORK _____________________ COUNTY, STATE OF UTAH TO ) ) ) MUTUAL PROTECTIVE GREETINGS: Petitioner, ) ORDER ) WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the ) Court vs. located at County of ) Civil No. in____________________________, room , on the day of , 20 ) , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the ) Judge Respondent. ) ____________________________, Your matter came for hearing on ___________________, a contempt undersigned.will make you liable to This failure to comply with this subpoena is punishable as before the of court and The the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. Petitioner and Respondent were both in attendance as were the following parties: Witness, Honorable attorney ____________________________, one of the Justices of the 9 Petitioner’s Court in County, 9 day of , 20 Respondent’s attorney __________________________ The Court having found that each party has filed a Petition for Protective Order, and having found that (Attorney must sign above and type name below) each party has committed abuse or domestic violence against the other, which abuse or domestic Attorney(s) for violence did not occur in self-defense, and having found the following circumstances justifying a mutual protective order: ______________________________________________________________________________ Office and P.O. Address ______________________________________________________________________________ ______________________________________________________________________________ 1 of 9 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: 8/03 American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. : IT IS HEREBY ORDERED JUDICIAL SUBPOENA Plaintiff(s) PURSUANT TO UTAH CODE SECTIONS 30-6-4.2 AND 30-6-4.5 THAT EACH PARTY IS -against: GRANTED A PROTECTIVE ORDER: (The Judge or Commissioner shall initial : each section that is included in this Order.) : _____ 1. Upon finding that both Petitioner and Respondent present a credible threat to the safety Defendant(s) : . . . . . . . . of .each. other,. . . . . .Petitioner. and. Respondent. . . . .restrained from attempting, committing, or . . . . . . . . . both . . . . . . . . . . . . . . . . . . . are . . . threatening to commit abuse or domestic violence against each other and both Petitioner and Respondent shall not stalk, harass, or threaten or use or attempt to use physical force that would reasonably be expected to cause physical THE PEOPLE OF THE STATE OF NEW YORK injury to the other. _____ 2. TO The Respondent is restrained from attempting, committing, or threatening to commit abuse or domestic violence against the designated minor children and family and household members and shall not stalk, harass, or threaten or use or attempt to use physical force that would reasonably be expected to cause physical injury to those parties. The designated minor children and members GREETINGS: of Petitioner’s family or household are: ________________________________________________________________________ WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court ________________________________________________________________________ located at County of in room ________________________________________________________________________ , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the __________________________________________________________________________ _____ Your failure to comply is restrained from attempting, committing, or threatening to commit abuse liable to 3. The Petitioner with this subpoena is punishable as a contempt of court and will make you the party on domestic violence against the was issued minormaximum penalty of $50 and all damages sustained as a whose behalf this subpoena designated for a children and family and household members and or result of your failure to comply. shall not stalk, harass, or threaten or use or attempt to use physical force that would reasonably be expected to cause physical injury to those parties. The designated minor children and members Witness, Honorable , one of the Justices of the of Respondent’s family or household are: Court in County, day of , 20 ________________________________________________________________________ ________________________________________________________________________ (Attorney must sign above and type name below) _________________________________________________________________________ Attorney(s) for _____ 4. Both Petitioner and Respondent are prohibited from directly or indirectly contacting, harassing, telephoning, e-mailing or otherwise communicating with each other. _____ 5. The Respondent shall be removed and excluded, and shall stay away, from the residence, Office and P.O. Address and its premises, located at: _________________________________________________________________________ and any subsequent residence of Petitioner known to the Respondent, and Respondent shall not Telephone No.: terminate or interfere with the utility services to the residence. 2 of 9 Facsimile No.: E-Mail Address: Mobile Tel. No.: 8/03 American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. : _____ 6. The Petitioner shall be removed and excluded, and shallJUDICIAL SUBPOENA stay away, from the residence, and Plaintiff(s) its premises, located at: -against: _________________________________________________________________________ and any subsequent residence of Respondent known to the Petitioner, and Petitioner shall not : terminate or interfere with the utility services to the residence. : _____ 7. The Respondent is ordered to stay away from the school, place of employment, and/or Defendant(s) : . . . . . . . . other.places,.and.their.premises,.frequented.by the Petitioner, the minor children and the designated .... ..... .. ... ....... ........ ........... household and family members. This includes any subsequent school, place of employment or other places known to the Respondent, which are frequented by the Petitioner or by the designated family and household OF NEW These THE PEOPLE OF THE STATEmembers. YORKplaces are identified by the following addresses: ________________________________________________________________________ TO ________________________________________________________________________ ________________________________________________________________________ GREETINGS: ________________________________________________________________________ WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable The Petitioner is ordered to stay away from the school, place of employment, and/or other at the Court _____ 8. located at County ofplaces, and their premises, frequented by the Respondent, the minor children and the designated in room householdon the , and family day of , 20 , at o'clock in the noon, and at any recessed members. This includes any subsequent school, place of employment or or adjourned date, to testify and give evidence as a witness in this action on the part of the other places known to the Petitioner, which are frequented by the Respondent or by the designated family and household members. These places are identified by the following addresses: ________________________________________________________________________ Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to ________________________________________________________________________ the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. ________________________________________________________________________ Witness, Honorable , one of the Justices of the ________________________________________________________________________ Court in County, day of , 20 _____ 9. Under state law pursuant to this order, the Court having found that Respondent’s use or possession of a weapon may pose a serious threat (Attorney must sign above andthe Respondent is of harm to Petitioner, type name below) prohibited from purchasing, using, or possessing a firearm or the following weapon(s): ________________________________________________________________________ Attorney(s) for ________________________________________________________________________ _____ 10. Under state law pursuant to this order, the Court having found that Petitioner’s use or possession of a weapon may pose a serious threat of Officeto Respondent, the Petitioner harm and P.O. Address is prohibited from purchasing, using, or possessing a firearm or the following weapon(s): ________________________________________________________________________ Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: ________________________________________________________________________ 3 of 9 8/03 American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. : ________________________________________________________________________ JUDICIAL SUBPOENA Plaintiff(s) -against- : ______11. The Petitioner is awarded possession of the following residence, automobile and/or : other essential personal effects: : ________________________________________________________________________ Defendant(s) ________________________________________________________________________ : ...................................................... ________________________________________________________________________ ________________________________________________________________________ THE PEOPLE OF THE STATE OF NEW YORK ________________________________________________________________________ TO ________________________________________________________________________ ________________________________________________________________________ GREETINGS: ________________________________________________________________________ This award is subject to that all business and excuses being laid future civil proceedings. WE COMMAND YOU, orders concerning the listed property in aside, you and each of you attend before , the Honorable The Respondent is awarded possession of the following residence, automobile and/or other at the Court _____ 12. located at County ofessential personal effects: in room ________________________________________________________________________ , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the ________________________________________________________________________ ________________________________________________________________________ Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to ________________________________________________________________________ the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. ________________________________________________________________________ Witness, Honorable , one of the Justices of the ________________________________________________________________________ Court in County, day of , 20 _________________________________________________________________________ (Attorney must sign above and type name below) This award is subject to orders concerning the listed property in future civil proceedings. _____ 13. An officer from the following law enforcement agency: ______________________ ___________________________shall facilitate the possession, exchange and removal of Attorney(s) for property as necessitated by the awards made in this Order. The parties shall not have any direct contact with each other. _____ 14. The Respondent is placed under the supervision of the Department of Corrections for the Office and P.O. Address purposes of electronic monitoring. Within 24 hours of the execution of this Order, the Department of Corrections shall place an electronic monitoring device on Respondent and shall install monitoring equipment on the premises of Petitioner and in No.: residence of Respondent. Telephone the 4 of 9 Facsimile No.: E-Mail Address: Mobile Tel. No.: 8/03 American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. : Respondent is ordered to pay to the Department of Corrections the costs of the electronic JUDICIAL SUBPOENA Plaintiff(s) monitoring required by this Order. The Department of Corrections shall have access to Petitioner’s -against: residence to install the appropriate monitoring equipment. : _____ 15. The Petitioner is placed under the supervision of the Department of Corrections for the : purposes of electronic monitoring. Within 24 hours of the execution of this Order, the Department of Corrections shall place an electronic monitoring device on Petitioner and shall install monitoring Defendant(s) : . . . . . . . . equipment. on .the .premises. of Petitioner .and. in. the.residence of Respondent. Petitioner is ordered ........ .. .. ...... .......... .. . .. ..... to pay to the Department of Corrections the costs of the electronic monitoring required by this Order. The Department of Corrections shall have access to Petitioner’s residence to install the appropriate monitoring equipment. THE PEOPLE OF THE STATE OF NEW YORK EITHER PARTY’S VIOLATION OF PROVISIONS “1” THROUGH “12” OF THIS ORDER TO IS A CLASS A MISDEMEANOR UNDER UTAH CODE SECTIONS 30-6-4.2(5) AND 76-5108. GREETINGS: IF EITHER PARTY’S VIOLATION OF PROVISIONS “1” THROUGH “12” IS A SECOND OR SUBSEQUENT DOMESTIC VIOLENCE OFFENSE, ENHANCED PENALTIES MAY BE before WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend , the Honorable UNDER UTAH CODE SECTIONS 77-36-1.1 AND 77-36-2.4. at the Court IMPOSED located at County of inThe following temporary reliefdaythe civil portion 20 this,protective o'clock in the room , on the , of at noon, and “t”) recessed in of order (provisions “a” throughat anyis or adjourned date, to testify and give evidence as a witness in this action on the part of the granted, which relief will (expire/be reviewed by the court) ______ days from the date of this order: _____ a. The Petitioner is granted custody of the following minor children: Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to ________________________________________________________________________ the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. ________________________________________________________________________ ________________________________________________________________________ Witness, Honorable Court in County, , one of the Justices of the day of , 20 _____ b. The Respondent is granted custody of the following minor children: ________________________________________________________________________ (Attorney must sign above and type name below) ________________________________________________________________________ _________________________________________________________________________ Attorney(s) for ______ c. Visitation shall be as follows: ________________________________________________________________________ Office and P.O. Address ________________________________________________________________________ ________________________________________________________________________ Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: ________________________________________________________________________ 5 of 9 8/03 American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. : ________________________________________________________________________ JUDICIAL SUBPOENA Plaintiff(s) -against________________________________________________________________________ : : _____ d. Both Petitioner and Respondent are restrained from using drugs and/or alcohol prior to or : during visitation. Defendant(s) : . ._____ . e.. . . . . .Both. Petitioner .and. Respondent. are. restrained .from removing the parties’ minor children ..... . ... ........ .. ......... .. ........ . from the state of Utah. _____ f. The Respondent is ordered THE PEOPLE OF THE STATE OF NEW YORK to pay child support in the amount of $__________________________ pursuant to the Utah Uniform Child Support Guidelines. TO _____ g. The Petitioner is ordered to pay child support in the amount of $__________________________ pursuant to the Utah Uniform Child Support Guidelines. GREETINGS: _____ h. The Respondent is ordered to participate in mandatory income withholding pursuant to Utah Code Annotated §that all business 4 and 5. WE COMMAND YOU, 62A-11, Parts and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at participate in mandatory income withholding pursuant to Utah County ofi. _____ The Petitioner is ordered to in room Code Annotated § 62A-11, Parts 4 and ,5. , on the day of 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the _____ j. The Respondent is ordered to pay one-half of the minor child/ren’s day care expenses. _____ Your failure to comply is ordered to pay one-half of the as a contempt of court care will make you liable to k. The Petitioner with this subpoena is punishable minor child/ren’s day and expenses. the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. _____ l. The Respondent is ordered to pay one-half of the minor child/ren’s medical expenses including premiums, deductibles and co-payments. Witness, Honorable Court in County, , one of the Justices of the day of , 20 _____ m. The Petitioner is ordered to pay one-half of the minor child/ren’s medical expenses including premiums, deductibles and co-payments. (Attorney must sign above and type name below) _____ n. The Respondent is ordered to pay spousal support in the amount of $__________. _____ o. The Petitioner is ordered to pay spousal support in the amount of $____________. Attorney(s) for _____ p. The Respondent is ordered to pay Petitioner’s medical expenses, suffered as a result of the abuse in the amount of $________________________. Office and P.O. Address _____ q. The Petitioner is ordered to pay Respondent’s medical expenses, suffered as a result of the abuse in the amount of $________________________. 6 of 9 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: 8/03 American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. : _____ r. The Respondent is ordered Plaintiff(s) minor child/ren’s medical expenses, suffered as a to pay the JUDICIAL SUBPOENA result of the abuse in the amount of $________________________. -against- : _____ s. The Petitioner is ordered to pay the minor child/ren’s medical expenses, suffered as a result : of the abuse in the amount of $________________________. : ______ t. Other: Defendant(s) : ...................................................... ________________________________________________________________________ ________________________________________________________________________ THE PEOPLE OF THE STATE OF NEW YORK ________________________________________________________________________ TO ________________________________________________________________________ Violation of provisions “a” through “t” may subject the parties to contempt proceedings. GREETINGS: ______ 16. The Division of Child and Family Services is ordered to conduct an investigation into the allegation of child YOU, that all business and excuses being laid aside, you and each of you attend before WE COMMAND abuse. , the Honorable at the Court located at County of 17. ______ A Guardian ad Litem is appointed to represent the best interests of the children. in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the ______ 18. Other: ________________________________________________________________________ Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to ________________________________________________________________________ the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. ________________________________________________________________________ Witness, Honorable , one of the Justices of the ________________________________________________________________________ Court in County, day of , 20 ________________________________________________________________________ ________________________________________________________________________ (Attorney must sign above and type name below) _________________________________________________________________________ Attorney(s) for 19. Under federal law, the Respondent and the Petitioner may be prohibited from purchasing, owning, transporting, using or possessing a firearm or ammunition. A violation of this prohibition may be a separate federal crime. There may be an exception for police and military personnel while on actual duty and those individuals should contact their immediate supervisors for further instructions. Office and P.O. Address 7 of 9 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: 8/03 American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. : 20. Law enforcement agencies with jurisdiction over the protected locationsSUBPOENA JUDICIAL shall have authority Plaintiff(s) to compel compliance with this Order, including the authority to forcibly evict and restrain the parties from -against: the protected areas. Information to assist with identification of the parties is attached to this Order. : 21. Petitioner and Respondent were afforded both notice and opportunity to be heard in the : hearing that gave rise to this order. Pursuant to the Violence Against Women Act of 1994, P.L. 103-322, 108 Stat. 1976, 18 U.S.C.A. 2265, this order is valid in all the United States, the District of Columbia, Defendant(s) : . .tribal .lands, .and United States .Territories.. . . . . . . . . . . . . . . . . . . .... .... .............. ........ 22. Two years after the date of this order, a hearing may be held to dismiss the remaining provisions of OF THE Within 30 NEW YORK THE PEOPLE the order.STATE OF days prior to the end of the two-year period, each party should provide the court with a current address, which address will not be made available to the other party. TO Note: This case was consolidated with case number _____________________________. GREETINGS: DATED: _____________________. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at County of in room , on the day of , 20 BY THE COURT: in the , at o'clock noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the _______________________________________ DISTRICT COURT of court Your failure to comply with this subpoena is punishable as a contempt JUDGE and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. Witness, Honorable Court in County, , one of the Justices of the day of , 20 Recommended by: (Attorney must sign above and type name below) _____________________________/___________________ Attorney(s) for District Court Commissioner Date Office and P.O. Address 8 of 9 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: 8/03 American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Plaintiff(s) -against- Calendar No. : JUDICIAL SUBPOENA : : : By this signature, Petitioner approves the form, and accepts service, of this Protective Order and waives the right to be personally served. Defendant(s) : ...................................................... ________________________________ Petitioner THE PEOPLE OF THE STATE OF NEW YORK Serve Petitioner at: TO Street:___________________________________ City/Town________________________________ GREETINGS: State/Zip_________________________________ WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located the County ofsignature, Respondent approvesat form, and accepts service, By this inof this Protective, Order and waives the right to be20 room on the day of , personally served. , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the _________________________________ Respondent failure to comply with this subpoena is punishable as a contempt of court and will make you liable to Your the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. Serve Respondent at: Witness, Honorable Street:____________________________________ Court in County, day of , one of the Justices of the , 20 City/Town_________________________________ State/Zip__________________________________ (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address 9 of 9 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: 8/03 American LegalNet, Inc. www.USCourtForms.com